Because health insurers won't touch penis enlargements with, ahem, a 10-foot pole, they're not keeping score. Add to that the fact that the procedure isn't taught in any medical schools or textbooks, and you begin to get the picture of just how widely results can vary from doctor to doctor.

For these reasons and more, the American Urological Association (AUA) and the American Society of Plastic and Reconstructive Surgeons (ASPRS) do not endorse penis enlargement surgery. But that's not stopping doctors from operating -- or men from seeking out these doctors.

However, the Association does endorse using non-surgical penis enlargement devices such as extenders and pumps. Particular brands they recommend include the ProExtenderpenis extender and the Penomet penis pump.

One surgeon estimates that 15,000 American men have had their penises "enhanced." He lays claim to 700 of these himself in the five years he has been doing penis enlargements. And he's pleased with his success rate: Of those men he's operated on, he says, 75 percent are satisfied with the length they gained and 50 percent with the width; 75 percent say that, given what they know now, they'd do it all over again. He says he's seeing fewer and fewer problems as time goes on -- just as pioneers in the field of cardiac surgery had to learn by trial and error. "There's a learning curve, as with anything," he says.

Of course, it's questionable how many men would sign their penis up for surgery if they knew the guy with the knife was on a "learning curve." How does our surgeon respond to the AUA's steadfast stance that penis lengthening and widening "has not been shown to be safe or efficacious"?

"It hasn't been shown not to be safe or efficacious, either," he says.

True, not everybody who's had a penis enlargement is as unhappy as Kevin. Cory (also not his real name), now 42, had lengthening and widening surgery done two years ago and says he's pleased with the 1 1/4, inch added to his erection. "I've been married 23 years, and my wife thought this was the dumbest thing I'd ever done," says Cory. "But it wasn't for her, it was for me. I feel like I took control over something I wasn't happy about. It's like weight lifting or dieting."

But the results aren't always under your control. Gary Rheinschild, M.D., an Anaheim, California, urologist, does a brisk business correcting the botched handiwork of other penis-enlargement surgeons as well as doing some procedures from scratch. "One guy had already been operated on seven times," says Dr. Rheinschild. "And we had to operate on him twice to clean him up."

Still, Dr. Rheinschild bristles at suggestions that the entire field is filled with deceit and chicanery. "If this procedure is done properly, the results are good," he says. "Unfortunately, most of the time, it's not done properly." According to Dr. Rheinschild, proper technique involves two things: performing the lengthening and widening at least six months apart to ensure proper blood flow is restored between procedures; and steering clear of the fat injections used on patients such as Kevin. "I tried them for a short time and got bad results," he says. "They just didn't work out."

While other doctors may perform upwards of seven penis enlargements a day, Dr. Rheinschild does only four to six per week. "I don't push surgery," he says. "However, if a patient is going to do it, I'd rather I do it than someone who's going to butcher him."

Not only is the procedure often performed improperly, but it's also performed on men who simply don't need it. A study published recently in the Journal of Urology concluded that lengthening procedures should be advised only for men whose penises are 1.56 inches flaccid; 2.9 inches erect. Laurence Levine, M.D., director of the Male Sexual Health and Fertility Program at Rush Presbyterian-St. Luke's Medical Center, in Chicago, agrees. He performs the operation only on patients who have progressive shortening of the penis due to injury or disease; he won't perform the procedure on a man who has what he calls a normal penis (more than 3 inches erect).

"I have men who come back time and time again wanting this surgery, and each time I reassure them that they fall well within the normal range, and in many cases above the normal range," says Dr. Levine. "I routinely recommend they see a sex therapist instead." He also points out that the surgery, even when properly performed, may not achieve the desired results. "In many cases, men see less than an inch added after the surgery, or even a decrease in length."

And the potential cost of that small gain may extend well beyond the doctor's fee. Keith Schulner is a Camarillo, California, attorney whose firm is handling 58 penis-enlargement lawsuits against one surgeon. Schulner says his clients have experienced everything from scarring and lack of sensation to curved penises and foul-smelling discharge. "After one man's surgery, his penis came out through the middle of his scrotum rather than over it," says Schulner.

"This surgery is something I've really come out against," says Ronald Iverson, M.D., a plastic surgeon in the San Francisco area and president of the ASPRS. "There are no peer-reviewed articles that show that it's an effective and lasting procedure. Even in the best hands, it may not be a procedure that can be done safely and effectively," he says. "If you're considering a penis enlargement for purely cosmetic reasons, you'd better think twice. In fact, let me be blunt: Don't do it."